Evidence map›Paper›PMID 39235671›Full record

ReviewArchives of osteoporosis2024

Similarities and differences between European guidelines for the management of postmenopausal osteoporosis.

Bernard Cortet, Núria Guañabens, Maria Luisa Brandi, Heide Siggelkow

Abstract readReviewComparative Study
In one paragraph

Review in Archives of osteoporosis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Pooled it
  4. Mechanisms underlying the waning of osteoanabolic therapy effects in osteoporosis.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026
    Review
  5. Low alkaline phosphatase in adults: implications for the diagnosis of hypophosphatasia during evaluation for osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
  6. Review
  7. [Metabolic bone disorders: what the internist must not overlook].Innere Medizin (Heidelberg, Germany) · 2026
    Review
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  14. Adequacy of pharmacological prescription in patients at very high risk of fracture within the FLS in Spain: analysis of the REFRA FLS-SEIOMM Registry.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Observational
  15. Barriers and solutions for global access to osteoporosis management: a Position Paper from the International Osteoporosis Foundation.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Bernard CortetDepartment of Rheumatology and ULR 4490 (MabLab), University-Hospital of Lille, Lille, France. bernard.cortet@chu-lille.fr.
Núria GuañabensRheumatology Department, Hospital Clinic, IDIBAPS, University of Barcelona, C. de Villarroel 170, 08036, Barcelona, Spain.
Maria Luisa BrandiItalian Bone Disease Research Foundation, Fondazione Italiana Ricerca Sulle Malattie Dell'Osso (FIRMO), Florence, Italy.
Heide SiggelkowDepartment of Trauma, Orthopedic and Reconstructive Surgery, University Medical Center Göttingen, Robert-Koch-Str, Göttingen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We conducted a review of 10 national guidelines from five EU countries to identify similarities or differences in recommendations for the management of patients with osteoporosis. We found general alignment of key recommendations; however, there are notable differences, largely attributed to country-specific approaches to risk assessment and reimbursement conditions.

introductionThe classification of fracture risk is critical for informing treatment decisions for post-menopausal osteoporosis. The aim of this review was to summarise 10 national guidelines from five European countries, with a focus on identifying similarities or differences in recommendations for the management of patients with osteoporosis.

methodsWe summarised the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Disease-International Osteoporosis Foundation guidelines and reviewed guidelines from France, Germany, Italy, Spain and the UK.

resultsThe approach to risk assessment differed across the guidelines. In France, and Spain, risk assessment was based on DXA scans and presence of prior fractures, whereas UK, German and Italian guidelines recommended use of a validated risk tool. These differences led to distinct definitions of very high and high-risk patients. Guidelines aligned in recommending antiresorptive and anabolic agents as pharmacologic options for the management of osteoporosis, with sequential treatment recommended. There was agreement that patients at high or very high risk of fracture or with severe osteoporosis should receive anabolic agents first, followed by antiresorptive drugs. Variations were identified in recommendations for follow up of patients on anti-osteoporosis therapies. Reimbursement conditions in each country were a key difference identified.

conclusionsCriteria for risk assessment of fractures differ across European guidelines which may impact treatment and access to anabolic agents. Harmonisation across EU guidelines may help identify patients eligible for treatment and impact treatment uptake. However, country-specific reimbursement and prescribing processes may present a challenge to achieving a consistent approach across Europe.

Indexed as

Bone Density Conservation AgentsOsteoporosis, PostmenopausalOsteoporotic FracturesEuropeFemaleHumansPractice Guidelines as TopicRisk AssessmentBone Density Conservation AgentsEuropean guidelinesFracture riskPostmenopausal osteoporosis

Identifiers

PMID39235671
PMCPMC11377466

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.